Abstract

Aims To determine the effect, if any, that hyper-hydration with hypotonic fluids has on sodium balance in paediatric haematology/oncology patients receiving cytotoxic chemotherapy treatment for malignancies.

Methods A literature review was carried out and a snapshot of current practice across paediatric haematology/oncology centres in the UK was obtained. A prospective study was carried out in a tertiary paediatric haematology/oncology centre. A total of 98 patient episodes involved hyper-hydration with isotonic 0.9% NaCl, almost isotonic 0.45% NaCl+2.5% glucose with added sodium bicarbonate or hypotonic 0.45% NaCl+2.5% glucose. Serum sodium was monitored before and during hyper-hydration. Results were analysed according to whether children experienced a drop in serum sodium.

Results Patients who were hyper-hydrated with hypotonic 0.45% NaCl & 2.5% Glucose experienced the greatest mean drop in serum sodium. The mean drop in sodium was 2.11 mmol/L in the group receiving the hypotonic 0.45% NaCl & 2.5% Glucose compared to 0.47 mmol/L in the group who received isotonic 0.9% NaCl or 0.45% NaCl & 2.5% Glucose with added sodium bicarbonate. During the course of the study five patients who received 0.45% NaCl & 2.5% Glucose dropped their sodium to 130 mmol/L or less constituting hyponatraemia. No patient dropped their serum sodium to 130 mmol/L or less in the other two groups. During the course of the study no patient experienced clinical manifestations of hyponatraemia. No child became hypernatraemic.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.